The effectiveness of heparin for thromboprophylaxis during microvascular free flap transfer is uncertain. The purpose of this meta-analysis was to determine the effect of heparin on the prevention of flap loss in microsurgical free flap transfer.A search of PubMed, Cochrane databases, and Google Scholar using combinations of the search terms heparin, free flap, flap loss, free tissue transfer w...

Permanent fecal abdominal stomas significantly decrease quality of life. Previous attempts to create continent stomas by using dynamic myoplasty procedures have resulted in disappointing outcomes, primarily owing to denervation atrophy of the muscle flap that was used in the creation of the sphincter and because of muscle fatigue resulting from continuous electrical stimulation that is received...

BACKGROUND Robots have allowed head and neck surgeons to extirpate oropharyngeal tumors safely without the need for lip-split incision or mandibulotomy. Using robots in oropharyngeal reconstruction is new but essential for oropharyngeal defects that result from robotic tumor excision. We report our experience with robotic free-flap reconstruction of head and neck defects to exemplify the necess...

OBJECTIVES/HYPOTHESIS Report on the successful use of the supraclavicular flap for reconstruction following total laryngectomy and highlight the utility and versatility of the supraclavicular flap for reconstruction after total laryngectomy. STUDY DESIGN Retrospective review of a single institution experience. METHODS A single institution database was reviewed to identify patients undergoin...

BACKGROUND Tissue expansion is a widely used technique to create skin flaps for the correction of sizable defects in reconstructive plastic surgery. Major complications following the inset of expanded flaps include breakdown and uncontrolled scarring secondary to excessive tissue tension. Although it is recognized that mechanical forces may significantly impact the success of defect repair with...

Variations of the distally based sural artery flap have been used in the literature with varying success rates. This article stresses the axiality of this flap based on the sural nerve and the short saphenous vein. Forty distally based sural artery flaps were used for a variety of defects in the distal leg. In the proximal leg, the groove between the medial and lateral heads of the gastrocnemiu...

Introduction. Submammary adipofascial flap (SMAF) is a valuable option for replacement of the inferior portion of the breast. It is particularly useful for reconstruction of partial mastectomy defects. It is also used to cover breast implants. Most surgeons base this flap cranially on the submammary skin crease, reflecting it back onto the breast. The blood vessels supplying this flap are not w...

Introduction: Free flap success rates have remained stable in recent years ranging 93% to 98%. Historically, the causes of free flap failures were attributed to the surgeon’s inexperience and technique. However, there are factors beyond the surgical anastomosis that contribute to flap failure. The purpose of this study is to review each case of total flap loss in detail to develop a better unde...

BACKGROUND Ischemic complications after nipple-sparing mastectomy (NSM) have been associated with numerous variables. However, the impact of NSM flap thickness has been incompletely evaluated. METHODS NSM flap thickness was determined for all NSMs from 2006 to 2016 with available pre- or postoperative breast magnetic resonance imaging (MRIs). Demographics and outcomes were stratified by those...

Abstract Anterolateral thigh (ALT) free flap is a commonly used for reconstruction of circumferential laryngopharyngeal defects. The harvested as an ellipse and tubed along its length. We would like to present design modification the ALT where tubing done width flap. This has advantages it allows two-layered closure without harvest additional tissue provides skin neck coverage also. After inset...